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  • Title: [Abducens nerve palsy due to postraumatic retroclival and spinal subdural hematoma: case report and literature review].
    Author: Catalá-Antúnez I, de Quintana-Schmidt C, Clavel-Laria P, Montes-Graciano G, Molet-Teixidó J.
    Journal: Neurocirugia (Astur); 2011 Aug; 22(4):337-41. PubMed ID: 21858408.
    Abstract:
    INTRODUCTION: Retroclival posttraumatic hematomas are extremely rare and almost exclusive to childhood. Only one case of retroclival subdural hematoma has been reported in the literature to date. CASE REPORT: An 8-year-old boy suffered a severe head injury with cervical hyperextension as the result of a bicycle accident. On admission his initial Glasgow Coma Score was 13 and he had diplopia due to right palsy of the VI nerve. A retroclival subdural hematoma was observed by CT and MRI of the craneovertebral junction. Management was conservative and a rigid collar was placed. Palsy of VI nerve recovered spontaneously at 6 days and at discharge the patient had only cervical pain. Follow up at 3 months after the accident showed clinical and radiological resolution. CONCLUSION: Traumatic retroclival hematomas are mainly a pediatric entity due to immaturity of the cranio-cervical junction. Treatment consists of placement of a rigid collar although clinical progression may require surgical evacuation.
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